I've been on Pregabalin 75mg for the last two days and had a good 8 hours of undisrupted sleep. I took it right before going to bed.
Although I am thankful that I can finally sleep through the night, I've been experiencing brain fog all day that I really dislike because it's as if I am in a dream all day.
1)
Are there any ways to reduce/eliminate the brain fog?
2)
Is it ok to take Pregabalin on a need basis? If it's ok, I want to try sleeping on some days with Pregabalin and on somedays without Pregabalin.
3)
Would reducing the dose to 50mg or 25mg reduce the severity of brain fog?
4)
Is it ok to stop the 75mg dosis after two days of use? Will I experience any withdrawal symptoms?
Thank you
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Ganadaramabasa
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The side effects usually go away after a few weeks. If you find they don't you might want to try switching to gabapentin. Although they are basically the same drug except you need to divide the doses, and the side effects are basically the same, some people find that the side effects that bother them on one don't bother them on the other. Multiply the pregabalin amount by 6 to get the correct dose. If you need more than 600 mg take the extra 4 hours before bedtime as it is not as well absorbed above 600 mg. If you need more than 1200 mg, take the extra 6 hours before bedtime. If you take magnesium, even in a multivitamin, don't take it within 3 hours of the gabapentin as it reduces the absorption of the gabapentin. If you take calcium don't take it within 2 hours for the same reason.
You can always come off pregabalin or gabapentin without withdrawal effects if you reduce very slowly. How slowly will depend on how long you are on them. Right now you could stop it as you have only been on it for 2 days. If you were on it for a long time you would need to reduce it by 25 mg every 2 weeks but if you continue to have brain fog that won't be the case. If you were on it say for several weeks to see if it goes away, you could probably reduce every 3 or 4 days.
Yes you can try reducing the dose so that your body can get used to it while you wait to see if it goes away.
I wouldn't take it on an as needed basis unless you were just on 25 mg and that won't help you get used to it.
Your recommendation of gabapentin dose and timings along with Salem.lake iron recommendation has literally given me my life back in just 6 days .Thankyou both .
Just a comment on gabapentin dosing: Unfortunately there is no simple rule for how much gabapentin would be equal to a particular dose of pregablin or for that matter to a particular dose of Horizant. In fact the reason that Horizant was developed in the first place (and so very likely also the reason that pregablin was developed) is this very uncertainty of dosage for gabapentin. Gabapentin is absorbed in the gut via a very small receptor area in the small intestine; and the size of this receptor area is determined genetically, and varies a great deal from one person to another. And there is no way to determine ahead of time how big or small the area is for you. So dosing of gabapentin as such is done by trial and error, slowly increasing a small starting dose until an effective dose level is reached. Sue is correct that the larger doses of gabapentin typically must be split into several smaller doses for best absorption. A good RLS doctor will know all about this.
Also I want to say that I’ve come to avoid “brain fog” as a term since (a) it sounds so vague & sinister and (b) it is not very useful for diagnosis. A more useful way to think of what happens in such cases, not only with gabapentin-type drugs but many other drugs - including opioids! - is “sedation.” Once we know that a particular drug can cause sedation, we also can be on the lookout for other problems that sedating drugs have - some of which can be quite serious.
A good example of this is that both gabapentin-type drugs and opioids, since they are sedating, can contribute to obstructive sleep apnea in vulnerable persons (overweight, large tongues or small jaws, etc.). And where the “brain fog” initially caused by such drugs often will go away after awhile, the contribution to apnea (if it occurs) will *never* go away. This was the case for me (which is how I learned about all this). Unfortunately even good RLS doctors can be under-educated about sleep issues outside of RLS, so you as a patient need to be the one to monitor your sleep quality (as well as daytime quality of life) and let your doctor know if for example your sleep has become non-refreshing , etc.
Give it a few weeks as the brain fog may reduce in time. Personally I wouldn't take it only as needed. I experience withdrawal type symptoms moving between doses (of 25mg). I have the impression that consistency is best with thus medication.
You may get used to it so if it’s working for now it might be worth persisting to see if it improves. However I personally came off it after a year as I didn’t want to be on medication and when I did it was a relief to have my mind clearer again. In my experience it wasn’t difficult to reduce. I was taking 300mg for a year and reduced in steps of 75mg which I hardly noticed.
2) Did taking Pregabalin for a year reduce the severity of PLMD? My understanding is it only relieves the symptoms and doesn't cure it, but I am just curious.
Hi, I was taking it for neuropathic pain and didn't notice any effect on my RLS although at the time I hadn't been diagnosed with RLS so it wasn't something I was watching for. However I was sleeping badly, presumably from the PLMD/RLS and the pregabalin didn't seem to make a difference to that. I don't take any medication now and I put up with waking 3 - 5 times a night and spending 1 -2 hours a night walking round the house and doing things like stretches and emptying the dishwasher. Normally 20 - 30 minutes activity is enough for me to get back to sleep.
I’m just switching from Tramadol to Pregabalin and the first 2 days was horrible, I was like a different person but now after a week there are no sideeffects durring the day, so I suggest you to keep taking pregabalin.
Hi there, yes the brain fog goes away. I started Pregabalin 2 months ago and the feeling through the day at first was concerning, just as you experience. I think within 5 days it had vanished but the medication keeps helping with that longed for sleep. I am on 100 mg each evening and may go up a bit as I further reduce my Pramipexole. I have no swelling or other side effects. 🤞 good luck!
Unfortunately I can’t take Pregabalin ,my doctor has gave me it to try but it did not agree with me , I’m glad it helps you , and you got a descant sleep for a change , I really hope it continues for you ,
Have you had your ferritin checked? If so, what was it? Improving your ferritin to 100 or more helps 60% of people with RLS and in some cases completely eliminates their symptoms. If not when you see your doctor ask for a full iron panel. Stop taking any iron supplements including multivitamins that have iron in them 48 hours before the test, don't eat a heavy meat meal the night before, fast after midnight and have your test in the morning before 9 am if possible. When you get the results, ask for your ferritin and transferrin saturation (TSAT) numbers. You want your transferrin saturation to be over 20% but less than 45% and your ferritin to be at least 100. If they are not, post them here and we can give you some advice.
Meanwhile some things that can make RLS symptoms worse for some people are alcohol, nicotine, caffeine, sugar, carbs, foods high in sodium, foods that cause inflammation, ice cream, eating late at night, estrogen including HRT, dehydration, MSG, collagen supplements, electrolyte imbalance, melatonin, stress and vigorous exercise. Some things that help some people include caffeine, moderate exercise, weighted blankets, compression socks, elastic bandages, masturbation, magnesium glycinate, fennel, low oxalate diet, selenium, 5 minute shower alternating 20 seconds cold water with 10 seconds hot water finishing with hot water for another couple of minutes, hot baths, distractions, CBD, applying a topical magnesium lotion or spray, doing a magnesium salts soak, vitamins B1, B3, B6, B12, D3, K2, if deficient, and potassium and copper if deficient, massage including using a massage gun, vibration devices, using a standing desk, listening to music, meditation and yoga. Keep a food diary to see if any food make your RLS worse
Many medicines and OTC supplements can make RLS worse. If you are taking any and you list them here, I can tell you if any make RLS symptoms worse and if so may be able to give you a safe substitute.
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